Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment

Николаевна, Диомидова Валентина; Тарасова, Л. В.; Цыганова, Ю. В.; Valeeva, Olga V.; Иванова, А. Л.

doi:10.31146/1682-8658-ecg-181-9-45-54

Cited by 7 publications

(3 citation statements)

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“…«Золотым стандартом» ранней диагностики неалкогольного стеатоза печени был и остаётся гистоморфологический анализ паренхимы печени, но показания к проведению биопсии крайне ограничены. На сегодняшний день достойную альтернативу среди неинвазивных методов диагностики способен предоставить эластографический методы оценки степени накопления жирового материала внутри гепатоцита -транзиентная эластография в режиме контролируемого параметра затухания (ТЭ в режиме КПЗ) [47].…”

Section: гомогенный энзиматический колориметрический тестunclassified

“…С целью оптимизации ранней диагностики НАЖБП с использованием современных индексов и биомаркёров на кафедре факультетской и госпитальной терапии «Чувашского государственного университета имени И. Н. Ульянова» в период с 2016 по 2020 гг было проведено исследование, включавшее несколько этапов. Эталонным методом определения ранней стадии НАЖБП -наличия неалкогольного стеатоза печени -были выбраны показатели ТЭ в режиме КПЗ, как наиболее информативные, но дорогостоящие малоинвазивные методы ранней диагностики НАЖБП [47,48].…”

Section: гомогенный энзиматический колориметрический тестunclassified

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Early diagnosis of non-alcoholic fatty liver disease: the role of biomarkers and complex indices of non-alcoholic fatty liver steatosis

Tarasova,

Tsyganova

2023

jour

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Metabolic syndrome is a series of pathologies united by a similar pathogenesis, the end of which, most often, is cardiovascular accidents, which are leaders among the causes of death in the population around the world. Non-alcoholic fatty liver disease (NAFLD) is the hepatic equivalent of the metabolic syndrome, registered earlier than all other equivalents, on the rights of the liver as a first-line energy depot. At the same time, according to multicenter studies, 95% of people with NAFLD (any stage) are not diagnosed with the disease. Clarification of additional risk factors for NAFLD and the presence of a specific biomarker of non-alcoholic liver steatosis would make it possible to stop the vicious cascade of metabolic processes, which in the future can lead to a significant increase in the life expectancy of the population. The potentially high role of Secreted Frizzled Related Protein-4 (SFRP4) adipokine in the early diagnosis of NAFLD is known. The aim of the study was to optimize the early diagnosis of non-alcoholic fatty liver disease using modern indices and biomarkers. Materials and methods. The work was carried out at the Department of Faculty and Hospital Therapy of the Chuvash State University named after I. N. Ulyanov” in the period from 2016 to 2020. This study included several stages: first of all, a retrospective analysis of 1150 outpatient records of patients from several medical organizations of the Chuvash Republic for the period 2016-2018 was carried out. to form two study groups: experimental and control. At the second stage, as a result of applying the exclusion criteria, 162 people remained in the experiment: 110 from the experimental group, 52 from the control group. The subjects of both groups were compared by gender and age, the age range of the subjects varied from 18 to 80 years old with an average value of 48.3 years. Further, the patients undergo a detailed examination, according to the presented plan: Collection of complaints, medical history, objective examination. Laboratory studies (general and biochemical blood tests, lipidogram, assessment of the level of serum adipokine SFRP4). Instrumental studies (ultrasound of the OBP, TE (SAR), ESP with elastometry). Evaluation of the most informative complex indices for the early diagnosis of NAFLD: MI, IVO indices, HSI, FLD-I. Further, all the necessary statistical processing and analysis of the obtained data were performed (Microsoft Office Excel 2016, StatTech v. 2.8.8 (developer - Stattech LLC, Russia)). Results. Accessible (not requiring the use of additional time and material costs) NAFLD indices with the highest sensitivity rates (99.1% and 98.2%, respectively) were MI and IVO. A noticeable direct correlation was traced between MI (p=0.640), moderate - between the IVO (p=0.398) and the elastographically determined index of non-alcoholic liver steatosis. High sensitivity and specificity of skin manifestations (xanthoma, xanthelasma - 69.6% and 89.7% and seborrheic dermatitis - 82.0% and 71.4%) were found in relation to early manifestations of NAFLD. From anthropometric indicators: the CW/CF index has a pronounced (ρ=0.643), CW - moderate (ρ=0.238), and BMI - a weak direct (ρ=0.223) correlation with the elastographically determined index of non-alcoholic liver steatosis. Adipokine SFRP4 correlates (ρ=0.841) with early manifestations of hepatic steatosis in patients, as determined by TE in CAP mode.

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Section: гомогенный энзиматический колориметрический тестunclassified

Early diagnosis of non-alcoholic fatty liver disease: the role of biomarkers and complex indices of non-alcoholic fatty liver steatosis

Tarasova,

Tsyganova

2023

jour

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“…Лучевая диагностика НАЖБП основывается на использовании ультразвукового исследования (УЗИ), компьютерной томографии (КТ) и магнитно-резонансной томографии (МРТ), чувствительность и специфичность которых значительно варьируют [7][8][9].…”

Section: Non-alcoholic Fatty Liver Disease In Patients With Type 2 Di...unclassified

Non-Alcoholic Fatty Liver Disease in Patients With Type 2 Diabetes: Modern Imaging Modalities

Babenko,

Laevskaya,

Meltonian

et al. 2023

Transl. med. (Print)

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Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide and one of the most common cause of liver transplantation in developed countries. Type 2 diabetes mellitus (T2DM) is an important risk factor for NAFLD. Additionally, T2DM is believed to accelerate the progression of NAFLD. Therefore, the use of different imaging modalities in this patient cohort appears to be more important than in patients with NAFLD without diabetes mellitus. Moreover, NAFLD is often overlooked in clinical practice. It should be noted that the gold standard for diagnosing NAFLD is still a liver biopsy, however, the method has a number of obvious disadvantages in terms of invasiveness, the impossibility of its frequent use in routine practice, its inapplicability for assessing the dynamics of NAFLD during treatment, and relatively high cost. In this regard, work is underway to find new non-invasive methods for diagnosing NAFLD, especially in the early stages. Radiation diagnosis of NAFLD is based on the use of ultrasound (ultrasound), computed tomography (CT) and magnetic resonance imaging (MRI), the sensitivity and specificity of which vary considerably. Thus, this review summarizes and discusses modern methods of non-invasive diagnosis of different types of NAFLD in patients with T2DM that can potentially have an important prognostic value.

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An algorithm for quantitative ultrasound steatometry of the liver: development of the technique and evaluation of its sensitivity, specificity, and reproducibility

Shestakova,

Borsukov

2024

Almanac of Clinical Medicine

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Rationale: Due to rising prevalence of metabolic syndrome, obesity and type 2 diabetes mellitus, the prevalence of metabolic-associated hepatic steatosis has amounted to 38–42% worldwide. The burden of its dangerous complications, such as steatohepatitis, liver fibrosis and cirrhosis, hepatocellular carcinoma, make the search for effective diagnostic methods of liver steatosis a priority. However, lack standardization of assessments reduces the accuracy and reproducibility of their results and requires elaboration of unified protocols for such assessments. Aim: To develop a unified algorithm for quantitative ultrasound steatometry of the liver and to evaluate its diagnostic accuracy (sensitivity, specificity, and reproducibility). Methods: This was a three step study, with its 1st part including 34 specialists on echography diagnostics aged 28 to 64 years with varying levels of experience (1 to 3 years, n = 5, 15.6%; 4 to 10 years, n = 18, 50%; 11 to 20 years, n = 8, 25%; ≥ 21 years: n = 3, 9.4%). The accuracy of quantitative ultrasound steatometry procedure evaluated with a test questionnaire, by analysis of archived echograms (340 clinical cases), and real-time ultrasound steatometry performed in 102 patients under the direct or remote supervision of the authors. In the 2nd part of the study we examined 173 patients with liver steatosis confirmed by multiparametric echography, comprehensive clinical and biochemical SteatoTest, magnetic resonance spectroscopy, multiaxial computed tomography with color mapping, dual-energy X-ray absorptiometry in the "whole body" mode, and histological examination of liver biopsy samples. In the 3rd part of the study we assessed the reproducibility of the quantitative ultrasound steatometry algorithm proposed by the authors, 12 ultrasound diagnostic physicians with varying levels of experience were involved (1 to 3 years: n = 3; 4 to 10 years: n = 3; 11 to 20 years: n = 3; more than 21 years: n = 3). Each physician examined 20 patients (5 patients in groups with no steatosis and with histologically confirmed steatosis of grades 1 to 3). Results: In the 1st part of the study, we identified the main patterns of quantitative ultrasound steatometry of the liver by specialists in the ultrasound diagnostics. Based on the international and Russian guidelines, as well as our own research, we proposed standardized operational procedure for quantitative ultrasound steatometry. The comparative analysis in the 2nd part of the study showed that the implementation of the operational procedure proposed by the author was associated with more narrow intervals for the ultrasound wave attenuation coefficient and better reproducibility, compared to the most common “rules” used by specialists in the ultrasound diagnostics. There were significant differences in the diagnosis of moderate and maximal steatosis with these two approaches (p 0.05). The sensitivity and specificity of the operational procedure proposed by the authors were 89% and 94%, respectively, compared to 75% and 79% for the commonly used approach. In the 3rd part of the study, there were no significant differences in the ultrasound wave attenuation coefficient measured by specialists with various levels of experience according to the authors’ algorithm. The inter-rater correlation coefficient was 0.948 (95% confidence interval [0.914; 0.973], p 0.001), confirming the authors method's high reproducibility and consistency. Conclusion: We have proposed an operational procedure for ultrasound quantitative steatometry of the liver, based on determination of the attenuation coefficient of the ultrasound wave in tissues. The implementation of this algorithm by medical specialists irrespective of their working experience provides high reproducibility of the method, with maximal sensitivity (89%) and specificity (94%).

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Ultrasound hepatic elastography with decaying signal technology allows assessing the degree of steatosis and dynamic monitoring of the effectiveness of NAFLD treatment

Cited by 7 publications

References 7 publications

Early diagnosis of non-alcoholic fatty liver disease: the role of biomarkers and complex indices of non-alcoholic fatty liver steatosis

Early diagnosis of non-alcoholic fatty liver disease: the role of biomarkers and complex indices of non-alcoholic fatty liver steatosis

Non-Alcoholic Fatty Liver Disease in Patients With Type 2 Diabetes: Modern Imaging Modalities

An algorithm for quantitative ultrasound steatometry of the liver: development of the technique and evaluation of its sensitivity, specificity, and reproducibility

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